A City Health Works client gets a house call from his health coachThomas Shomaker

City Health Works enlists East Harlem residents to make health calls to their at-risk neighbors.

In 2013, the New York City Health Department declared a diabetes epidemic in the city. The number of people who had contracted the disease had more than doubled in a decade. Part of the problem, they stressed, was a lack of information about the disease, noting that about a third of adults who had diabetes were unaware of it.

That same year, Manmeet Kaur founded City Health Works, a nonprofit based in East Harlem, which she hoped could provide a unique messenger to deliver this information to patients: their neighbors. City Health Works hired and trained six men and women from the neighborhood as health coaches. They meet one-on-one with more than 200 patients in East Harlem who have or are at risk of chronic diseases and conditions, like diabetes, to provide information and assist them in changing their habits.

Kaur says that City Health Works has reduced blood sugar levels for its diabetic patients by more than 1 point, on average, in its first year.